Harmful effects of fentanyl on the fetus and placenta?

Sedgwick, Joseph A.; Schenbeck, Jennifer L.; Eghtesady, Pirooz

doi:10.1016/j.ajog.2005.01.084

Cited by 7 publications

(1 citation statement)

References 4 publications

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“…Interestingly, Carotti et al (6) observed that methylprednisolone administration prior to fetal bypass lowers fetal glucose values compared with controls; however, this therapy did not prevent metabolic acidosis as intended. Our group and others have reported that high-dose opiate-based fetal anesthesia (e.g., fentanyl), comparable to clinical practice of cardiac surgery, is actually detrimental to the fetus (41,43). These findings highlight the importance of further studies on management of the fetal stress response and optimal anesthetic regimen for the fetus.…”

Section: Discussionmentioning

confidence: 62%

Changes in fetal ovine metabolism and oxygen delivery with fetal bypass

Lam

Baker

Clark³

et al. 2011

American Journal of Physiology-Regulatory, Integrative and Comp

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Since the 1980s, attempts at experimental fetal cardiac bypass for the purpose of correcting severe congenital heart defects in the womb have been hampered by deterioration of placental function. This placental pathophysiology in turn affects transplacental transport of nutrients and gas exchange. To date, the effects of bypass on fetal metabolism and oxygen delivery have not been studied. Nine Suffolk sheep fetuses from 109-121 days gestation were instrumented and placed on fetal bypass for 30 min and followed postbypass for 2 h. Blood gases, glucose, and lactate were serially measured in the fetal arterial and umbilical venous circulations throughout the procedure. Insulin and glucagon levels were serially measured by immunoassay in fetal plasma. Fetal-placental hemodynamics were measured continuously. The expression of glycogen content was examined in fetal liver. Oxygen delivery to the fetus and fetal oxygen consumption were significantly deranged after the conduct of bypass (in-group ANOVA (P = 0.001) and overall contrast (P = 0.072) with planned contrast (P < 0.05) for delivery and consumption, respectively). There were significant alterations in fetal glucose metabolism in the postbypass period; however, insulin and glucagon levels did not change. Fetal liver glycogen content appeared lower after bypass. This is the first report documenting fetal metabolic dysregulation that occurs in response to the conduct of fetal bypass. The significant alterations in fetal oxygen and glucose delivery coupled with hepatic glycogen depletion complicate and impede fetal recovery. These initial findings warrant further investigation of interventions to restore metabolic and hemodynamic homeostasis after fetal bypass.

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Section: Discussionmentioning

confidence: 62%

Changes in fetal ovine metabolism and oxygen delivery with fetal bypass

Lam

Baker

Clark³

et al. 2011

American Journal of Physiology-Regulatory, Integrative and Comp

Self Cite

View full text Add to dashboard Cite

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Current awareness: Pharmacoepidemiology and drug safety

2006

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 20 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Anesthesia for Fetal Surgery

Tran¹,

Cohen²

2011

Smith's Anesthesia for Infants and Children

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Harmful effects of fentanyl on the fetus and placenta?

Cited by 7 publications

References 4 publications

Changes in fetal ovine metabolism and oxygen delivery with fetal bypass

Changes in fetal ovine metabolism and oxygen delivery with fetal bypass

Current awareness: Pharmacoepidemiology and drug safety

Anesthesia for Fetal Surgery

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